'Thatcher film offers chance to end the taboo of dementia'

'Out of the shadows': Paul Burstow wants London to be the first capital city to be 'dementia-friendly'

About 40,000 Londoners are suffering from dementia without realising that they have the condition, the government minister in charge of mental healthcare reveals today.

Many face "a miserable life" of increasing isolation because of a taboo that discourages friends and relatives from telling them they need help, said Paul Burstow.

"Families don't broach the issue, despite often making cryptic remarks about how 'dad's getting a bit forgetful' or 'he doesn't know where the car keys are'," he told the Evening Standard.

"It is a tragedy because if we knew who they are then we could help them."

It is a deeply unfashionable topic, but one that has become a dinner party talking point because of the award-winning movie The Iron Lady.

While David Cameron criticised Meryl Streep's portrayal of a frail and forgetful Margaret Thatcher, Mr Burstow sees the controversy as a chance to haul the growing epidemic "out of the shadows". He said: "Some people have said the movie is despicable and outrageous but I can't help but think that if it makes people more aware and less fearful of dementia - and makes them understand that this disease can strike any one of us - then it's a good thing.

"Cancer used to be the disease that people didn't want to talk about, but it has come out of the shadows in recent years and people are more up-front about it.

"Dementia has taken its place. It is the stigma that comes with it. We now know that people in their fifties fear dementia most of all - more than cancer even."

The figures he reels off point to a huge iceberg of a problem lying below the surface of London society. The Health Department estimates that 65,000 Londoners have dementia, of which 26,000 are being treated.

That means six in 10 sufferers have never talked to their doctor about it and probably do not know. Most are elderly, but a small number are in their thirties or forties.

Diagnosis rates vary wildly between London care trusts, with Newham and Islington identifying well over half their local victims, while Barking & Dagenham identifies just 28 per cent.

"That means there are an awful lot of people who frankly are having a miserable life and when things go wrong for them, they might go into hospital, receive poorer care and stay in hospital longer. It's a huge issue."

Although there is no cure, sufferers can be helped to get back in control of their lives and plan for the disease's progression.

Mr Burstow, the Sutton & Cheam MP, wants London to become the first capital in the world to be recognised as a "dementia-friendly city" - where shops, Tube stations, superstores and cinemas train staff to help confused people.

"In York, there is an Asda that meets and greets people. East Coast is training staff to help confused people get off at the right station and liaise with transport police where necessary. It's all about breaking down the terrible social isolation that dementia can cause.

"Can London be the first dementia-friendly capital? It's a huge challenge and one that the candidates for Mayor should be talking about."

Mr Burstow is a key figure in cross-party talks on how care homes and personal care for the frail elderly will be paid for in the future, with a ballooning pensioner population. Formal talks with Labour began in private this week and he hopes they can agree on legislation to go through Parliament before 2015.

The minister said his "starting point" was the recommendation by economist Andrew Dilnot for each person's contribution towards their own care to be capped at a level, such as £35,000 or more.

"It's not a blueprint but a building guide," he said, making clear that he expects something similar to be agreed.

He is firmly against the proposals for assisted dying for the terminally ill, championed by author Sir Terry Pratchett and MS sufferer Debbie Purdy.

"As a Christian I could not square it with my conscience," he said. "I don't believe you could ever make enough safeguards to be sure someone has not been manipulated, put under emotional pressure to say 'yes'."

The Liberal Democrat made clear his disapproval of David Cameron using the term "Tourette's" as a jibe against Labour's Ed Balls. "It's a good thing in politics when you make a mistake that you are prepared to say 'I'm sorry, got that wrong'."

Alarmed by high rates of mental illness among offenders, he said prisons should be used for treatment and rehabilitation rather than just punishment. "We've spent 14 years with ministers trying to sound tough on crime, but not nearly enough talking about how to reduce the reservoir of criminals."

He speaks approvingly of Justice Secretary Kenneth Clarke, who has challenged the Home Office's drive for longer sentences. "There are Liberals of all hues in the Coalition and not all are card-carrying Liberal Democrats."

Mr Burstow, a former Lib-Dem chief whip, admitted that May's council and London contests will be "a challenging set of elections" for his party.

He thinks Brian Paddick, the former senior police officer who trailed third in the 2008 mayoral race will do better. Then, he was "very green, finding his way round, but this time he has served his apprenticeship and is a much stronger candidate. I think he will give tired Ken and Boris a run for their money."